The hard part is separating the cases where it is used improperly from the cases where it is helping the health of the players.
Like if you make a rule that players need to get off LTIR and play at least X games before the playoffs to be eligible. I can see it resulting in players with real injuries getting rushed to play before they are fully healed so that they can make the deadline.
Looking at it, I think the core problem is conflict of interest. By having the team both able to decide when a player goes on/off LTIR, and the team benefitting from it, you have created a situation where the team has an incentive to be less than honest.
A fix could be to split up the process. For example, the team can only request a player be considered for LTIR, but the players association with their own doctors are responsible for deciding if it actually qualifies to start, and when the player is healthy enough to end it. That way the team loses enough control that they cannot reliably game it, they have to be ready to react when a 3rd party ends the LTIR.
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